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The Next Revolution: Percutaneous Aortic Valve Replacement

Aortic valve replacement (AVR) is a treatment of choice for patients with symptomatic severe aortic stenosis (AS). However, a significant proportion of these patients do not undergo surgical AVR due to high-risk features. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative f...

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Autores principales: Leon, Martin B., Nikolsky, Eugenia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Rambam Health Care Campus 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678783/
https://www.ncbi.nlm.nih.gov/pubmed/23908788
http://dx.doi.org/10.5041/RMMJ.10016
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author Leon, Martin B.
Nikolsky, Eugenia
author_facet Leon, Martin B.
Nikolsky, Eugenia
author_sort Leon, Martin B.
collection PubMed
description Aortic valve replacement (AVR) is a treatment of choice for patients with symptomatic severe aortic stenosis (AS). However, a significant proportion of these patients do not undergo surgical AVR due to high-risk features. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative for patients with severe AS who are not candidates for open-heart surgery. Since the introduction of TAVI to the medical community in 2002, there has been an explosive growth in procedures. The balloon-expandable Edwards SAPIEN valve and the self-expanding CoreValve ReValving(TM) system contribute the largest patient experience with more than 10,000 patients treated with TAVI to date. Clinical outcomes have stabilized in experienced hands, with 30-day mortality less than 10%. Careful patient selection, growing operator experience, and an integrated multidisciplinary team approach contribute to notable improvement in outcomes. In the first randomized pivotal PARTNER trial, in patients with severe AS not suitable candidates for surgical AVR, TAVI compared with standard therapy, significantly improved survival and cardiac symptoms, but was associated with higher incidence of major strokes and major vascular events. The results of randomized comparison of TAVI with AVR among high-risk patients with AS for whom surgery is a viable option are eagerly awaited to provide further evidence on the applicability of TAVI in these patients.
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spelling pubmed-36787832013-08-01 The Next Revolution: Percutaneous Aortic Valve Replacement Leon, Martin B. Nikolsky, Eugenia Rambam Maimonides Med J Rambam Grand Rounds Aortic valve replacement (AVR) is a treatment of choice for patients with symptomatic severe aortic stenosis (AS). However, a significant proportion of these patients do not undergo surgical AVR due to high-risk features. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative for patients with severe AS who are not candidates for open-heart surgery. Since the introduction of TAVI to the medical community in 2002, there has been an explosive growth in procedures. The balloon-expandable Edwards SAPIEN valve and the self-expanding CoreValve ReValving(TM) system contribute the largest patient experience with more than 10,000 patients treated with TAVI to date. Clinical outcomes have stabilized in experienced hands, with 30-day mortality less than 10%. Careful patient selection, growing operator experience, and an integrated multidisciplinary team approach contribute to notable improvement in outcomes. In the first randomized pivotal PARTNER trial, in patients with severe AS not suitable candidates for surgical AVR, TAVI compared with standard therapy, significantly improved survival and cardiac symptoms, but was associated with higher incidence of major strokes and major vascular events. The results of randomized comparison of TAVI with AVR among high-risk patients with AS for whom surgery is a viable option are eagerly awaited to provide further evidence on the applicability of TAVI in these patients. Rambam Health Care Campus 2010-10-31 /pmc/articles/PMC3678783/ /pubmed/23908788 http://dx.doi.org/10.5041/RMMJ.10016 Text en Copyright: © 2010 Leon and Nikolsky. This is an open-access article. All its content, except where otherwise noted, is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Rambam Grand Rounds
Leon, Martin B.
Nikolsky, Eugenia
The Next Revolution: Percutaneous Aortic Valve Replacement
title The Next Revolution: Percutaneous Aortic Valve Replacement
title_full The Next Revolution: Percutaneous Aortic Valve Replacement
title_fullStr The Next Revolution: Percutaneous Aortic Valve Replacement
title_full_unstemmed The Next Revolution: Percutaneous Aortic Valve Replacement
title_short The Next Revolution: Percutaneous Aortic Valve Replacement
title_sort next revolution: percutaneous aortic valve replacement
topic Rambam Grand Rounds
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678783/
https://www.ncbi.nlm.nih.gov/pubmed/23908788
http://dx.doi.org/10.5041/RMMJ.10016
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